Breathing techniques and respiration devices become more and more popular among asthmatics and people with other respiratory problems. Among the known breathing techniques is the Buteyko breathing method, which had six randomised controlled trials in western countries.

The results were remarkable: twice less steroids, 3-10 times less reliever medication, better quality of life and less asthma symptoms, but unchanged bronchial responsiveness or lung function results after several months of breathing exercises. Meanwhile, all these studies had a major methodological flaw, which I am going to consider here.

Dr. K. Buteyko made the following clinical statements:

• Sick people, asthmatics including, breathe more air at rest than the minuscule medical norm (chronic hyperventilation). Overbreathing reduces tissue oxygenation and strengthens the desire to breathe even more.

• If they normalize their breathing pattern, then they will not require medication and will not experience their symptoms.

• The Buteyko Table of Health Zones relates breathing parameters of sick people, regardless of the name of the disease, with their current health state. This table describes parameters that reflect normal breathing (8 breaths/min for breathing frequency at rest, 6.5 percent for alveolar CO2 content, 60 seconds for stress-free breath holding time after usual exhalation, etc.). These parameters correspond to normal health and absence of asthma and many other chronic diseases since normal breathing improves body oxygenation.

• Someone has mastered the Buteyko breathing method, if his breathing parameters are normal.

Dr KP Buteyko never made claims that a particular Buteyko practitioner could achieve a particular result in relation to some group of asthmatics. Let us apply these Buteyko’s claims to available scientific data and the results of these randomised controlled trials.

First of all, hundreds of scientific research publications have shown that hyperventilation DIMINISHES oxygen content in body tissues.

Do asthmatics breathe much more air than the medical norm? A typical respiratory minute ventilation for an average asthmatic is about 12-15 L of air in one minute at rest (5 publications are available on my website), while the medical norm is only 6 L/min. Therefore, asthmatics breathe at rest about 2-2.5 times more air than the physiological standard.

Did asthmatics improve their breath parameters during these randomised controlled trials of the Buteyko breathing method? During the most impressive study (Bowler et al, 1998), in 3 months, use of relievers was reduced by 96 percent (25 times less ventolin) and preventers or inhaled steroids by 50%. Respiratory minute volume decreased from their initial 14 L/min to 9.6 L/min, but the physiological norm is only 6 L/min, while Dr. Buteyko’s hard standard is 4 L/min at rest for a 70-kg man. Hence, during their best shot, the participated asthmatics got only about a half way towards the standard. Consequently, there were a very few asthmatics, if any, who normalized their breath during these trials. They continued to hyperventilate.

The assumption of the medical doctors, who conducted these randomised controlled trials, was that a Buteyko teacher taught the Buteyko breathing method and a controlled group "learned" the method. This is easy to see from the titles, which usually say about a "trial of the Buteyko method". How could they study the method, if no one learned it?

From a practical view, since I taught the Buteyko method to hundreds of people, the key difficulty during these randomised controlled trials were the following. The participants were mainly limited to practicing breathing exercises (e.g., 40-70 min per day). They could not use the versatile arsenal of life-style addressing tools of the Buteyko method. Breathing normalization process requires 24/7 control of breathing including:

• nasal breathing all the time (hence, it is necessary then to seal one’s mouth with a surgical tape, if the mouth is usually dry in the morning; and someone will never solve their problems with asthma, if mouth breathing occurs during each night

• physical exercise (no less than 2 hours daily with only nasal breathing, in and out, otherwise exercise is more or less ineffective for most, especially sick people)

• prevention of sleeping on one’s back (we breathe about two times more air, when we sleep on our backs at night)

• and various other lifestyle-related factors so that one’s basal breathing pattern is restored back to our physiological standard.

Even more successful results have been discovered after application of the Frolov Breathing Device during recent clinical trails in Russia (under review and to be published in 2011).